From the Department of Radiology, Keck Hospital of the University of Southern California, 1500 San Pablo St, Los Angeles, CA 90033.
Radiographics. 2017 Nov-Dec;37(7):1928-1954. doi: 10.1148/rg.2017170050.
The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward function. The anatomy of the pulmonary veins is variable among patients, with several noteworthy variant and anomalous patterns, including supernumerary pulmonary veins, a common ostium, anomalous pulmonary venous return, and levoatriocardinal veins. Differences in pulmonary vein anatomy and the presence of variant or anomalous anatomy can be of critical importance, especially for preoperative planning of pulmonary and cardiac surgery. The enhancement or lack of enhancement of the pulmonary veins can be a clue to clinically important disease, and the relationship of masses to the pulmonary veins can herald cardiac invasion. The pulmonary veins are also an integral part of thoracic interventions, including lung transplantation, pneumonectomy, and radiofrequency ablation for atrial fibrillation. This fact creates a requirement for radiologists to have knowledge of the pre- and postoperative imaging appearances of the pulmonary veins. Many of these procedures are associated with important potential complications involving the pulmonary veins, for which diagnostic imaging plays a critical role. A thorough knowledge of the pulmonary veins and a proper radiologic approach to their evaluation is critical for the busy radiologist who must incorporate the pulmonary veins into a routine "search pattern" at computed tomography (CT) and magnetic resonance imaging. This article is a comprehensive CT-based imaging review of the pulmonary veins, including their embryology, anatomy (typical and anomalous), surgical implications, pulmonary vein thrombosis, pulmonary vein stenosis, pulmonary vein pseudostenosis, and the relationship of tumors to the pulmonary veins. Online supplemental material is available for this article. RSNA, 2017.
肺静脉将含氧的血液从肺部输送到心脏，但它们对放射科医生的重要性远远超出了这一看似简单的功能。肺静脉的解剖结构在患者之间存在差异，有几种值得注意的变异和异常模式，包括额外的肺静脉、共同的口、异常肺静脉回流和左旋心静脉。肺静脉解剖结构的差异以及变异或异常解剖结构的存在可能具有至关重要的意义，特别是对于肺和心脏手术的术前规划。肺静脉的增强或缺乏增强可能是临床重要疾病的线索，而肿块与肺静脉的关系可能预示着心脏侵犯。肺静脉也是胸部介入的一个组成部分，包括肺移植、肺切除术和射频消融治疗心房颤动。这一事实要求放射科医生了解肺静脉的术前和术后影像学表现。许多这些手术都与涉及肺静脉的重要潜在并发症相关，其中诊断成像起着至关重要的作用。对于必须在计算机断层扫描（CT）和磁共振成像中将肺静脉纳入常规“搜索模式”的忙碌放射科医生来说，全面了解肺静脉及其正确的评估方法至关重要。本文是一篇基于 CT 的肺静脉综合影像学综述，包括其胚胎学、解剖学（典型和异常）、手术意义、肺静脉血栓形成、肺静脉狭窄、肺静脉假性狭窄以及肿瘤与肺静脉的关系。本文提供了在线补充材料。RSNA，2017 年。
